In Preparation for a Treatment Guideline for Suitable Vascular Access Repair in Japan

: In cases of vascular access (VA) for hemodialysis including arteriovenous fistula and arteriovenous graft, venipuncture and hemostasis are usually repeated three times a week. Accordingly, it is assumed that VA vascular disorders are worsened following long‐term hemodialysis. In particular, angio...

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Bibliographic Details
Published in:	Therapeutic apheresis and dialysis Vol. 10; no. 4; pp. 364 - 371
Main Authors:	Amano, Izumi, Ohira, Seiji, Goto, Yasuo, Hino, Ichiro, Ikeda, Kiyosi, Kukita, Kazutaka, Haruguchi, Hiroaki
Format:	Journal Article
Language:	English
Published:	Melbourne, Australia Blackwell Publishing Asia 01-08-2006
Subjects:	Angioplasty, Balloon Anti-Bacterial Agents - therapeutic use Bacterial Infections - drug therapy Catheters, Indwelling - adverse effects Constriction, Pathologic - etiology Constriction, Pathologic - surgery Graft Occlusion, Vascular - therapy Humans Hypertension - etiology Hypertension - therapy Japan Practice Guidelines as Topic Renal Dialysis Steal syndrome Stenosis Surgical Wound Infection - drug therapy Surgical Wound Infection - etiology Thrombotic occlusion Vascular access intervention Venous hypertension Venous Thrombosis - etiology Venous Thrombosis - therapy Japan
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Summary:	: In cases of vascular access (VA) for hemodialysis including arteriovenous fistula and arteriovenous graft, venipuncture and hemostasis are usually repeated three times a week. Accordingly, it is assumed that VA vascular disorders are worsened following long‐term hemodialysis. In particular, angiostenosis frequently occurs and results in insufficient blood flow or increased venous pressure. Additionally, stenosis is a major cause of VA occlusion. While VA intervention treatment is mainstream for VA stenosis, its major advantage lies in its less invasiveness because it is a percutaneous treatment. A further advantage of this treatment procedure is that the existing VA can be preserved intact. For practical use of VA intervention treatment, however, compliance with the therapeutic indication guideline is required. In K/DOQI of the United States, such a guideline has already been formulated based on evidence and specialist opinion, while the guideline of the European Vascular Access Society is presented in the form of a flowchart. The Japanese Society for Dialysis Therapy is currently preparing a guideline for the construction and maintenance of VA, which introduces the timing and principles of repair of VA in the following six categories: (i) stenosis; (ii) occlusion; (iii) venous hypertension; (iv) steal syndrome; (v) excess blood flow; and (vi) infection. Except for infection, most of the treatments for these events involve VA intervention, thus the need for the guideline for VA intervention treatment is becoming widely recognized.
Bibliography:	ark:/67375/WNG-JJN1LVWF-R ArticleID:TAP390 istex:713CC81B0E467552948822A0A7393AA17BA18743 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1
ISSN:	1744-9979 1744-9987
DOI:	10.1111/j.1744-9987.2006.00390.x